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- Title
In-Hospital Formula Supplementation in Appalachian Women Intending to Exclusively Breastfeed.
- Authors
Alqudah, Elham; Davis, Amy; Berzingi, Seher; Webster, Katherine; Thompson, Stephanie; Evans, Cortney; Cross, Kimberly
- Abstract
Objective: In-hospital formula supplementation places infants at risk for early breastfeeding cessation. The study's aim was to identify predictive and protective factors for in-hospital formula supplementation in individuals documented as wanting to exclusively breastfeed and residing in a geographic region with adverse social determinants of health and low breastfeeding rates. Additionally, we wished to determine if lactation consultation served as a protective factor against supplementation. Methods: In this cross-sectional study, we retrospectively reviewed 500 randomly selected charts of newborns born in a 12 month period at a regional tertiary care hospital. We included healthy, full-term neonates having a recorded maternal decision to exclusively breastfeed. Maternal-newborn dyad characteristics were compared between those exclusively breastfeeding and those with in-hospital formula supplementation. Results: Of the 500 charts, 70% of individuals desired to exclusively breastfeed. Overall, 41% of breastfed newborns were supplemented with formula before discharge, and 32% of women met with lactation consultants prior to supplementation. No statistically significant association was present between exclusive breastfeeding at discharge and meeting with a hospital lactation consultant (p = 0.55). When controlling for the confounders of maternal demographics and lactation consultation, significant associations with formula supplementation included Cesarean delivery (odd ratio: 2.08, 95% confidence interval: 1.04–4.16), primiparity (2.48, 1.27–4.87), and high school level of education (2.78, 1.33–5.78). Conclusions: Maternal characteristics of high school level educational, primiparity, and Caesarean delivery place individuals at risk for in-hospital formula supplementation in individuals wishing to exclusively breastfeed. Addressing barriers to exclusive breastfeeding is essential to enhance maternal and newborn health equity. Significance: What is already known on this subject? Exclusive breastfeeding is recognized as the ideal feeding method for infants. Newborns receiving formula in-hospital are at higher risk for early breastfeeding cessation. Rural residence and/or in the Appalachian region negatively impact breastfeeding rates. What this study adds? Predictors for in-hospital formula supplementation in women desiring to exclusively breastfeed included high school level educational, primiparity, and C-section delivery. Lactation consultation did not associate with decreased initiation of formula supplementation.
- Subjects
APPALACHIAN Region; INFANT formulas; STATISTICS; LACTATION; STATISTICAL significance; CONFIDENCE intervals; CROSS-sectional method; MULTIVARIATE analysis; MULTIPLE regression analysis; AGE distribution; WOMEN; RETROSPECTIVE studies; TERTIARY care; MANN Whitney U Test; FISHER exact test; RACE; DIETARY supplements; T-test (Statistics); BREASTFEEDING; PARITY (Obstetrics); CHI-squared test; MEDICAL referrals; DESCRIPTIVE statistics; ODDS ratio; MARITAL status; DATA analysis software; EDUCATIONAL attainment
- Publication
Maternal & Child Health Journal, 2024, Vol 28, Issue 2, p324
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-023-03830-1